Biomimetic implants for pelvic floor repair

Vashaghian, Mahshid; Zaat, S.A.J.; Smit, Theo H.; Roovers, Jan‐Paul W. R.

doi:10.1002/nau.23367

Cited by 28 publications

(17 citation statements)

References 145 publications

(306 reference statements)

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“…Tissue engineering of degradable electrospun meshes with eMSC have demonstrated improvements in mesh integration. Electrospinning is an emerging versatile method of mesh construction that uses electric forces to draw charged threads of polymer solution together to create ultrafine meshes that allow for host immune cells to adhere in both nanofibrous and microfibrous formats [ 80 , 81 ]. These emerging biomimetic electrospun meshes produce an ECM-like topography that mimic the ECM of vaginal tissue of women with POP at the nanoscale [ 73 ].…”

Section: Engineering Novel Meshes With Emscmentioning

confidence: 99%

“…The ability to purify and characterise these cells through relatively non-invasive procedures has encouraged a separate investigation into their potential therapeutic applications in various clinical conditions with significant burden of disease [ 60 ]. As described, the restorative and regenerative capacity of autologous and heterologous perivascular eMSC is under investigation for applications in POP [ 8 , 11 , 19 , 39 , 44 , 72 , 73 , 74 , 76 , 79 , 80 , 81 ]. In particular, autologous ovine eMSC have persisted 30 days in a non-degradable PA mesh seeded with eMSC in situ in a transvaginal POP surgery model [ 72 ], xenogenic human eMSC for 1–2 weeks when implanted in a non-degradable PA+G composite mesh in immunocompromised rodent models of subcutaneous wound repair, and for 3 days in immunocompetent mice [ 70 ].…”

Section: Potential Clinical Applications Of Emscmentioning

confidence: 99%

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Endometrial SUSD2+ Mesenchymal Stem/Stromal Cells in Tissue Engineering: Advances in Novel Cellular Constructs for Pelvic Organ Prolapse

Hennes

Rosamilia

Werkmeister

et al. 2021

JPM

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Cellular therapy is an emerging field in clinical and personalised medicine. Many adult mesenchymal stem/progenitor cells (MSC) or pluripotent derivatives are being assessed simultaneously in preclinical trials for their potential treatment applications in chronic and degenerative human diseases. Endometrial mesenchymal stem/progenitor cells (eMSC) have been identified as clonogenic cells that exist in unique perivascular niches within the uterine endometrium. Compared with MSC isolated from other tissue sources, such as bone marrow and adipose tissue, eMSC can be extracted through less invasive methods of tissue sampling, and they exhibit improvements in potency, proliferative capacity, and control of culture-induced differentiation. In this review, we summarize the potential cell therapy and tissue engineering applications of eMSC in pelvic organ prolapse (POP), emphasising their ability to exert angiogenic and strong immunomodulatory responses that improve tissue integration of novel surgical constructs for POP and promote vaginal tissue healing.

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Section: Engineering Novel Meshes With Emscmentioning

confidence: 99%

Section: Potential Clinical Applications Of Emscmentioning

confidence: 99%

Endometrial SUSD2+ Mesenchymal Stem/Stromal Cells in Tissue Engineering: Advances in Novel Cellular Constructs for Pelvic Organ Prolapse

Hennes

Rosamilia

Werkmeister

et al. 2021

JPM

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“…This is in order to avoid the adverse events often associated with new released implants. Ultimately, as suggested by Vashaghian et al, clinical application should start with small patient studies with detailed follow‐up to evaluate mesh safety and efficacy (Vashaghian et al, ).…”

Section: Future Perspectivementioning

confidence: 99%

“…This positively contributes to the development of meshes able to induce a constructive remodeling process, by achieving a wider range of degradation profiles as well as mechanical properties, and thus matching better the host tissue needs and regenerative potential (Hympánová, Rynkevic, Román, et al, 2018). Additionally, the pliability and adjustable stiffness of electrospun meshes help in preventing the formation of fibrous and scartype tissue that, beyond bearing a high risk of contraction, represents one of the greatest challenges of conventional knitted POP implants (Vashaghian, Zaat, Smit, & Roovers, 2018).…”

Section: Research On Pelvic Tissue Regenerationmentioning

confidence: 99%

“…After 24 weeks of implantation in a rat abdominal wall model, multiple complications were observed except from the solid PCL-CTGF mesh delivering rMSC, which showed better biomechanical as well as biochemical outcomes in comparison to the same mesh incorporated with bFGF. (Hansen et al, 2019) PCL/PEO-fibrinogen/bFGF solid fibers 1.61 ± 0.13 1.5 ± 0.4 PCL/PEO-fibrinogen/CTGF solid fibers studies with detailed follow-up to evaluate mesh safety and efficacy (Vashaghian et al, 2018).…”

Section: Electrospun Nanomaterials-based Meshesmentioning

confidence: 99%

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The use of polymeric meshes for pelvic organ prolapse: Current concepts, challenges, and future perspectives

et al. 2019

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Pelvic organ prolapse (POP) is one of the most common chronic disorders in women, impacting the quality of life of millions of them worldwide. More than 100 surgical procedures have been developed over the decades to treat POP. However, the failure of conservative strategies and the number of patients with recurrence risk have increased the need for further adjuvant treatments. Since their introduction, surgical synthetic meshes have dramatically transformed POP repair showing superior anatomic outcomes in comparison to traditional approaches. Although significant progress has been attained, among the meshes in clinical use, there is no single mesh appropriate for every surgery. Furthermore, due to the risk of complications including acute and chronic infection, mesh shrinkage, and erosion of the tissue, the benefits of the use of meshes have recently been questioned. The aim of this work is to review the evolution of POP surgery, analyzing the current challenges, and detailing the key factors pertinent to the design of new mesh systems. Starting with a description of the pelvic floor anatomy, the article then presents the traditional treatments used in pelvic organ disorders. Next, the development of synthetic meshes is described with an insight into how their function is dependent on both mesh design variables (i.e., material, structure, and functional treatment) and surgical applications. These are then linked to common mesh‐related complications, and an indication of current research aiming to address these issues.

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Supramolecular Fibrous Hydrogel Augmentation of Uterosacral Ligament Suspension for Treatment of Pelvic Organ Prolapse

Miller

Wolfe

Gentry

et al. 2023

Adv Healthcare Materials

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Uterosacral ligament suspension (USLS) is a common surgical treatment for pelvic organ prolapse (POP). However, the relatively high failure rate of up to 40% underscores a strong clinical need for complementary treatment strategies, such as biomaterial augmentation. Herein, the first hydrogel biomaterial augmentation of USLS in a recently established rat model is described using an injectable fibrous hydrogel composite. Supramolecularly‐assembled hyaluronic acid (HA) hydrogel nanofibers encapsulated in a matrix metalloproteinase (MMP)‐degradable HA hydrogel create an injectable scaffold showing excellent biocompatibility and hemocompatibility. The hydrogel can be successfully delivered and localized to the suture sites of the USLS procedure, where it gradually degrades over six weeks. In situ mechanical testing 24 weeks post‐operative in the multiparous USLS rat model shows the ultimate load (load at failure) to be 1.70 ± 0.36 N for the intact uterosacral ligament (USL), 0.89 ± 0.28 N for the USLS repair, and 1.37 ± 0.31 N for the USLS + hydrogel (USLS+H) repair (n = 8). These results indicate that the hydrogel composite significantly improves load required for tissue failure compared to the standard USLS, even after the hydrogel degrades, and that this hydrogel‐based approach can potentially reduce the high failure rate associated with USLS procedures.

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Biomimetic implants for pelvic floor repair

Cited by 28 publications

References 145 publications

Endometrial SUSD2+ Mesenchymal Stem/Stromal Cells in Tissue Engineering: Advances in Novel Cellular Constructs for Pelvic Organ Prolapse

Endometrial SUSD2+ Mesenchymal Stem/Stromal Cells in Tissue Engineering: Advances in Novel Cellular Constructs for Pelvic Organ Prolapse

The use of polymeric meshes for pelvic organ prolapse: Current concepts, challenges, and future perspectives

Supramolecular Fibrous Hydrogel Augmentation of Uterosacral Ligament Suspension for Treatment of Pelvic Organ Prolapse

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